New research on infants presumed to be affected by Zika virus in the womb shows that the infection can take a serious toll on a baby’s eyes, causing harm that could lead to severe visual impairment.
Two scientific papers about eye abnormalities possibly linked to the virus were recently published by Stanford University and Brazilian researchers.
The first study found several previously unreported signs of retinal problems in the back of the eye, including hemorrhaging, blood vessel abnormalities and a kind of eye lesion called torpedo maculopathy not noted before in relation to Zika virus. Some of the retinal vasculature appeared to be missing in one infant, a type of problem that could result in blind spots or decreased peripheral vision. Retinal hemorrhaging, or bleeding in the eye, can result in vision loss if untreated.
“These are serious eye problems,” said Darius Moshfeghi, M.D., author and professor of ophthalmology at Stanford University School of Medicine. “Retinopathy and loss of the retinal vasculature can result in progressive disease resulting in blindness.”
The study was published online Wednesday in Ophthalmology, journal of the American Academy of Ophthalmology.
The three Brazilian babies in this case study also had microcephaly, a condition known to be caused by the virus that results in a smaller-than-normal head and brain. They were all born to women who displayed signs of the infection during the first trimester. The authors say it remains unclear whether the viral infection caused the eye abnormalities or if they are related to microcephaly brought on by the virus.
The other study also found eye abnormalities in babies born to women affected by Zika and identified possible associated risk factors. Researchers looked at 40 infants with microcephaly born in Pernambuco state, Brazil. The authors say ocular problems were more often seen in infants with smaller heads. They also found more eye irregularities in infants whose mothers reported symptoms during the first trimester. Many of the babies had signs of eye lesions similar to those in the other study.
“We have seen over 200 children with microcephaly, from which over 40 percent of the confirmed Zika cases have severe ocular lesions,” said Rubens Belfort, Jr., M.D., Ph.D., head professor of ophthalmology at the Federal University of Sao Paulo in Brazil and author of the second paper, published in JAMA Ophthalmology.
As the outbreak continues, the number of children at risk of ocular and developmental issues from Zika virus appears to be growing.
Recently, the CDC reported that nearly 280 pregnant women in the United States and its territories may now have the virus, likely due to travel. Some 4,000 babies in Brazil reportedly have microcephaly from presumed congenital Zika infections. The incidence rate in Brazil is approximately 20 times the rate recorded before the outbreak. As a result of the widespread birth defects associated with the virus, the World Health Organization called a public health emergency.
“Zika infection would appear to be a very important public health issue due to vision loss, in addition to other developmental abnormalities in the brain,” said Michael X. Repka, M.D., clinical spokesperson for the American Academy of Ophthalmology and a pediatric ophthalmology researcher at Johns Hopkins University School of Medicine.
Even small case studies like these add important clinical information to the limited body of knowledge about this spreading infectious disease, he added.
Expanded Spectrum of Congenital Ocular Findings in Microcephaly with Presumed Zika Infection, Ophthalmology, published online May 25, 2016.
Risk Factors Associated With Eye Abnormalities in Infants with Presumed Zika Virus Infection, JAMA Ophthalmology, published online May 26, 2016